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diagnosis hepatology treatment lfts algorithm biliary differential gastroenterology pbc primary transaminitis acute aih autoimmune canimorsus capnocytophaga causes checklist chemistry cholangitis
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Severe - ALT >15X ULN ... Moderate - ALT 5-15X ULN ... Mild - ALT < 5x ULN ... Congenital, Others, Cirrhosis
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Severe ALT > 15x ULN ... Moderate ALT 5-15x ULN ... Mild ALT < 5x ULN ... disease US — Normal ... Infiltrative • Cirrhosis
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
(>10^6 IU/mL), normal ... Family history of cirrhosis ... IU/mL and ALT > ULN ... or fibrosis • Cirrhosis ... #Indications #management
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
upper limit of normal ... Hepatitis (eg Viral) Management ... ALT + AST > 5x ULN ... AND IgG > 2x ULN ... AIH #Diagnosis #Management
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
Primary Biliary Cirrhosis ... cholestasis → Cirrhosis ... • ALT & AST normal ... • ALP > 1.5 x ULN ... Primary #Biliary #Cirrhosis
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
R-value: Serum (ALT/ULN ... ALT) / (Alk phos/ULN ... - If both are normal ... of ALP • Near normal ... hepatitis: < 1 • Cirrhosis
Capnocytophaga Pathogen: Capnocytophaga • 9 species, C. canimorsus responsible for the majority of infections • Gram-negative rod,
, alcohol use, Cirrhosis ... the cytoplasm of PMN ... infectiousdiseases #diagnosis #management
Multiple Sclerosis - Summary Multiple Sclerosis (MS) is an autoimmune-mediated neurodegenerative disease of the central nervous system
Examination: • UMN ... Hyperreflexia, Clonus, Babinski ... sclerosis #diagnosis #management
Primary Biliary Cirrhosis - Management A. Initiate therapy - Initiate 1st line therapy with UDCA (13-15
Primary Biliary Cirrhosis ... - Management A ... if ALP > 1.5x ULN ... and/or abnormal ... Primary #Biliary #Cirrhosis
Acute Pancreatitis - Diagnosis and Management - GrepMed Handbook Presentation: • Epigastric abdominal pain (90%, characteristically
Diagnosis and Management ... 2) Lipase > 3x ULN ... diagnosis, can be normal ... hemorrhage Management ... diagnosis and management
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